To describe the usefullness of the screening tools to determine the suspicion of a cognitive impairment in low-incomes settings (LIS) in Jipijapa, a rural city of Manabí, Ecuador.

We assessed all patients who fully accept to take all 3 test (MMSE, Mini-Cog and Photo test) between September and October 2020 in the rural setting of Jipijapa, Ecuador; and we compared the capability to determine the presence of cognitive impairment against MMSE, using correlations test and AUC (ROC) curve to determine the best cut-point, sensitivity and specificity of the tests, adjusted by education level. 

We assessed 94 patients, with high rates of low-literacy (42,6%), 61,7 % were women, the median age was 64 (±18) years-old, the mean in all test was significantly different in the low-educated versus middle and high-educated patients (MMSE: 20±4 Vs. 26±3; Photo-Test: 29±8 Vs. 39±9; Mini-Cog: 2±1 Vs. 3±2).  We found a positive relation between MMSE and both test (Photo-Test: r=0,738; Mini-Cog: r=0,514; p<0,001). The AUC was bigger in the PhotoTest than Mini-Cog (80,8% Vs. 78,8%) with the best cut-off points for Photo-Test of 32/33 (S:83%, E:80%) and for Mini-Cog was 2 (S:92%, E:57%). 

Both Mini-Cog and Phototest may be used as screening tools in LIS patients in suspicion of cognitive impairtment.